The Aging of the Epidemic: Older New Yorkers Living With HIV/AIDS

There's a growing recognition among healthcare and AIDS professionals that HIV/AIDS is no longer a death sentence, evolving into a chronic yet manageable disease for many people living with the disease.

Yet this latter scenario isn't always the case, particularly for New Yorkers aging with the disease. In a story published by the New York Times over the weekend, middle-aged and older adults living with the disease face specific challenges, including accelerated aging and treatment ineffectiveness.

According to the best estimates, nearly half of New Yorkers with HIV are now 50 or older, and most express frustration with the troubling sentiment that the disease is "over" or inconsequential, with many advocates shifting focus from HIV/AIDS advocacy to fighting for marriage equality and visibility in mainstream media and politics. This sentiment of erasure is especially troubling when New York City continues to be one of the largest epicenters of the disease.

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For one, many middle-to-older adults living with HIV/AIDS are experiencing aging symptoms and complications that are typically found in bodies 10-20 years older. Arthritis, memory loss, kidney failure or damage, diabetes, chronic fatigue, elevated blood pressure, thyroid disease and general malaise have all been found to affect adults aging with the disease, though it is unclear if this early onset is due to the disease, treatments, or a yet to be determined combination of both. As some of the first to be affected by the disease, as well as the first generation to age with the disease, many researchers suggest the medications may play a large part in this early aging, which is explored at length in a 2009 article by David France in New York Magazine titled "Another Kind of AIDS Crisis."

Others have found their bodies will no longer respond to once-effective medications.

Scott Jordan, 52, for example, discovered "the last treatment available to him is no longer effective." He had taken a brief break from his meds after experiencing severe complications, which allowed a brief respite but only at the cost of increased amounts of the virus in his blood. When he returned to his meds, he found that they are incapable of bringing his viral low down.

Scott opined that it's not only the slow progress of new drugs that worries him, but also the invisibility and invalidation of people's "internal experiences." Indeed, while older adults experience social isolation at higher rates than their younger counterparts, social isolation among adults aging with the disease is thought to be widespread as well, especially among those who have seen their lovers, friends, and family die from the disease. What's more, 75% of HIV-positive New Yorkers who are 50 and older currently live alone, which can drive depression as well as a dip in adherence to treatment regimens.

Above all, the adults interviewed in the New York Times article stressed that the disease is far from over, and that their lives should not be treated as invisible. As Osvaldo Perdomo, board member from GMHC, stated, "People think it's over, you can just take a pill, there's a cure around the corner. It drives me crazy when people think it's over."

This article was provided by Housing Works. It is a part of the publication Housing Works AIDS Issues Update. Visit Housing Works' website to find out more about their activities, publications and services.

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